Disease Knowledge and Attitudes toward Predictive Testing and Prenatal Diagnosis in Families with Machado-Joseph Disease from the Azores Islands (Portugal)Lima M.a · Kay T.b · Vasconcelos J.c · Mota-Vieira L.e · Gonzalez C.d · Peixoto A.f · Abade A.g · MacLeod P.i · Graça R.h · Santos J.c
aDepartment of Biology, University of the Azores, Departments of bClinical Genetics, cNeurology, dClinical Psychology, eUnit of Genetics and Molecular Pathology, fSocial Services, Hospital Divino Espirito Santo, St. Miguel, Azores, gDepartment of Anthropology, University of Coimbra, Coimbra, hDepartment of Neurology, Hospital of Angra do Heroismo, Terceira, Azores, Portugal, and iDepartment of Medical Genetics, Victoria General Hospital, Victoria, B.C., Canada
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Objective: Machado-Joseph disease (MJD) reaches its highest prevalence world-wide in the Azores, thus constituting a public health problem in these islands. The aim of the study was thus to (1) determine the level of knowledge about the disease; (2) estimate the expected level of request for predictive testing, and (3) analyse the intentions of at-risk individuals concerning their reproductive decisions. Methods: A questionnaire on these points was distributed to 42 affected and 36 at-risk individuals. Results: As expected, the educational level of the respondents was significantly associated with the level of knowledge about the disease. The survey indicated that 83.3% of the at-risk individuals would make use of a predictive test and that 77.8% would make use of prenatal diagnosis. Of the latter, 36.1% would terminate the pregnancy if confronted with a positive result for the fetus. Conclusions: The level of knowledge about MJD in the Azorean families is considered to be fair. Although the actual behavior can prove to be different from the intentions put forward by at-risk individuals based solely on the results of this study we can estimate that the request for a predictive test would be quite high. The intentions expressed by at-risk individuals seem to indicate that the prenatal diagnosis will have an effect on their reproductive decisions. Results obtained certify the importance of implementing genetic testing for MJD in the Azores.
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